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Homelike design makes extended care facilities more livable

Input proves valuable from seniors'Our people are constantly surprised by the tremendous enthusiasm they find when we ask them what they want. And they're not at all shy about telling you.'

Posted: Tuesday, January 09, 2001

ROSEVILLE, Minn. -- A Southwestern decorating theme would seem natural for a health care complex in Sun City, Ariz.

But one-on-one interviews with the people who were going to live there showed that they had other ideas.

''It turns out they were from out East and they didn't want Southwest. They wanted to bring part of their home with them,'' said Charles Shuster, executive vice president of Arthur Shuster Inc., which handled the design job in 1984.

Those pioneering interviews are now routine for ASI, helping make it a leader in the move to design and furnish nursing homes and assisted living facilities that feel more like a home than an institution.

''Our people are constantly surprised by the tremendous enthusiasm they find when we ask them what they want,'' said James Moeller, ASI design director. ''And they're not at all shy about telling you.''

''One resident told us, 'We don't want any of that ... country music on the elevator,''' Moeller recalled with a laugh.

ASI, based in Roseville, brings in $35 million to $45 million a year for designing and furnishing the interiors of long-term health care communities and extended-stay hotels around the country.

About 70 percent of the company's business is in health care, more than half for nonprofit groups.

Most projects range between $450,000 and $600,000 but have gone as high as $4 million, Shuster said. The projects range from modest, government-funded facilities to elaborate complexes funded privately.

''We've learned a lot since 1984 about what seniors want,'' Shuster said. ''Taking institutional-looking buildings and making them residential has helped create an environment where people can live out their lives and be happy. The stigma of a nursing home is gone.''

Mary Louise Raynor, director of vendor relations for the American Association of Homes and Services for the Aging, said health care facilities are no longer places where people go to die.

''It's had a hospitality element added to it. Now it's much more warm and fuzzy,'' Raynor said.

The demand for continuing care retirement communities -- including independent living, assisted living (with meals, cleaning services and available health care) and nursing home care -- is growing as baby boomers and their parents age.

In 1990, 51 million Americans were older than 55; that number is expected to increase to about 94 million by 2020.

Amenities at the centers are plenty, from computer rooms where residents can send e-mail, shop on the Internet and do research to library areas stocked with books, newspapers and magazines. Billiard rooms, fitness centers, card rooms, garden rooms and aviaries also are common. One ASI-designed facility even has a large quilting room.

At Rosewood Estate in St. Paul, Minn., sunlight streams through the skylight into a garden room filled with green and flowering plants.

''That's what I call my labor of love,'' said Dorothy Rowell, 89, a resident who tends the plants brought in by colleagues. ''That's Dorothy's garden. They call me the Plant Lady.''

Rowell, one of the first residents of the 5-year-old facility, also enjoys playing the organ for other residents. ''I have never missed my home since I left,'' Rowell said.

She doesn't venture into the computer room, though.

''I know nothing of the new stuff, and it's going to stay that way, too,'' she said. ''Some of them do, but most of the people my age just don't get into that, especially the women.''

Breaking away from institutional design can sometimes be a trick.

When ASI first began recommending that floors in health care facilities be carpeted rather than tiled, for example, some people resisted because of fears about keeping the carpet clean.

''Shiny floors are a disaster for old people. They look wet and slippery and hard and residents don't venture out. A carpeted environment is more comfortable,'' Moeller said.

ASI asked a manufacturer to develop a carpet that was impervious to moisture and could be glued to the floor without a pad, which can trap urine and other moisture. Wheelchairs also move better over unpadded carpet.

The company has learned not to use dark strips of carpeting in front of doorways. ''Most residents with Alzheimer's won't cross because they see it as a moat, a hole,'' Shuster said.

Chairs and couches have firm cushions so residents don't have trouble getting up after sitting, and are arranged in small groups throughout public areas to encourage residents to interact.

In assisted-living apartments, electrical outlets are about two feet above the floor so residents don't have to bend down as far. Cabinets over counters in the kitchen area are lower so they can be used by residents in wheelchairs. Bedrooms often have walk-in closets.

Ceilings are lower, and windows are smaller and decorated with draperies and valances to absorb sound.

''The elderly feel diminished in great big spaces,'' Moeller said.

ASI uses a different color scheme on each floor and different furniture at the end of each corridor to help residents find their way. Many facilities with dementia patients have memory boxes outside each door with photos and other items from the past to help identify their home.

At the recently completed Maple Village in Detroit, owned by Lutheran Social Services of Michigan, ASI designed an elegant split staircase leading from the ground floor to second floor.

''The staircase was put there to promote independence. Very few people will actually use it, but it's an example of independence. This is what they lived with. This is how they grew up,'' Shuster said.

At Longview Assisted Living Residence, part of the Christian Health Care Center in Wychoff, N.J., a room combines music, soft lights, gentle vibration, tactile sensations and aromatherapy to stimulate residents with Alzheimer's.

''We wanted smaller intimate spaces as if you were walking into the entrance of someone's home. They did capture that for us,'' said Nancy Turick, vice president of planning for the center.

Environment can't be an afterthought, Shuster said.

''This is not a passage place. This is the last place,'' he said.



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